Tuesday, May 10, 2016

Cookie's Lumpectomy Update

As you can imagine, since the moment I found the bump on Cookie's belly I was concerned. The vet's reaction to it made my worries only worse. The wait for the pathology results wasn't going to be easy.

Jasmine's vet also recommended cold packs to help with the pain at the incision site.
Cookie, however, hates getting these things, whether hot or cold. She had solved this
for herself by making a nice cool hole in the ground to lay on. Not ideal but it worked.

Fortunately the wait for results on the removed bump was much shorter than the wait for the aspirate would have been.

When Cookie's physical therapist looked at it just before we left on our trip, she was reasonably convinced it was a histiocytoma. I would have gone for that. The fact that it seemed to have cropped-up over night would support that. The fact that it was on the belly not so much.

The vet who examined it definitely didn't think that's what it was.

Another potential good option would have been a sebaceous adenoma. Again, I found a couple of photos that kind of looked like what Cookie had on her belly. I'd take either of those.

But I had to wait for the pathology results.

They were supposed to come in on Thursday. Since the moment I woke up that was all I could think about. I really wanted to call the vet and find out. But I really didn't want to find out it was something cancerous. So I decided to pretend being patient waiting for the vet to call.

Time was passing by.

It was four in the afternoon when I finally couldn't take it and called. "It just came in," the vet said. "It was indeed a histiocytoma."

Yes! Yes! Yes! A histiocytoma.

I think I actually might have been jumping up and down at hearing that. Cookie's PT called it! It was a great news.

Theoretically, we could have left it be and see if it was going to go away on its own. Theoretically, we could have done the aspirate and spared Cookie going through the surgery. It wasn't bothering her.

On the other hand we didn't know that and it did look suspicious. And, according to the report, it was already ulcerating.

We did what we thought best at the time we made the decision.

Fortunately, the surgery went really well and Cookie had no issues with coming out of the anesthesia or the incision.

She was such a good girl leaving it alone, not only she didn't need the cone of shame but we didn't even need to cover it with a t-shirt which we got specifically for that purpose. Compared to the horror trying to get JD leave his incisions alone, this was a walk in the park. All we had to do was to make sure it didn't get wet. Because Cookie continued going for her physical therapy, even though she had to skip the underwater treadmill part, it was regularly seen and also lasered for faster healing.

The only issue was pain management.

When talking to the local vet who was going to do the surgery, she was asking whether Cookie was on NSAIDs. Which she wasn't. We used it only short term for both the iliopsoas injury and then the new injury at the beginning of the year for which it didn't seem to have done much anyway.

We discussed Deramaxx versus Meloxicam. The vet felt that Meloxiam works better for post-op situations. I was concerned about the delivery, as this comes as a liquid in a syringe. Would Cookie accept it? But I was told that it has a honey flavor and dogs love it. So we agreed on going with that.

However, after the surgery, Cookie was sent home without anything at all.

By later afternoon she started showing signs of pain. She wasn't comfortable laying down, wondering around. I knew it meant her incision was hurting. And of course it would. Ever had a paper cut? Well, this was one enormous paper cut.

I called Jasmine's vet. He always sends his patient home with two pain management meds, no matter how little the surgery. Since Cookie's latest blood work looked great and we still had some Deramaxx on hand, it was decided to start her on that. I gave it to her right away.

Because NSAIDs need to be given with food, I gave her her dinner for late lunch along with it. In about half an hour since giving it to her, I could see it started making her feel better.

I was hoping that the next day I could hold off till dinner time. But the effect lasted almost exactly 24 hours when I could see signs of discomfort coming back. So instead of pushing the medication off till dinner time, I had to push dinner time up to the late afternoon.

With the addition of having it lasered regularly, Cookie only needed the pain meds for four days.

Cookie's stitches should come out on Friday.

Everything has been healing nicely and if the stitches are ready come out, Cookie can resume her hydrotherapy on the same day.

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Disclaimer: Information published on this blog are my opinions and findings the way I understand them. I try to provide good information, but my main goal is to get you to get educated and come to your own understanding of things.